Recent advances in SMANCS/Lipiodol therapy for hepatic and other abdominal cancers are discussed. Two clinical procedural progresses described herein are arterial infusion of SMANCS/Lipiodol under angiotensin II induced hypertension (eg. 120 → 180 mmHg), which is followed by, or commitant infusion of SMANCS/Lipiodol and nitro-agent (nitroisosorbitol : nitrol
®) i. a. via the catheter inserted at the femoral artery (Seldinger's method). SMANCS/Lipiodol is selectively deposited much higher extent by virtue of EPR-effect and this amount was increased 2∼4 fold under hypertensive condition followed by opening up the normal blood vessels by Nitrol
® : This procedure also reduced side effect clinically to a great extent such as liver toxicity. X-ray CAT scan revealed much thickened uptake of SMANCS/Lipiodol in case of the metastatic liver cancer, cholangiocarcinoma, and pancreatic cancer, as well as hepatocellular carcinoma. For highly enhanced tumor selective delivery of SNIANCS/Lipiodol given i. a., the method using two vascular mediators (hypertension/systemic : vasodilatation/local) is more desirable than simple i. a. infusion, which resulted far better drug deposition and response, as well as QOL of the patients, than original SMANCS therapy under normotensive state.
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